Hi Kay - So sorry you are in pain. I had great luck on Nortriptyline but I do not get headaches - just all the other neurological symptoms in force. I start on 25mgs, then 50, then 25, then 10 for a total of 12 weeks. For me, I need 25 mgs for 5 days before it kicks in. Side effects will be dry mouth, constipation and fatigue in the AM. My doctor says to take the night dose early to reduce a.m. fatigue. Also, taking magnesium helps constipation and is on the suggested list for MAV patients. Also, eat lots of veggies and salads at dinner. Drink lots of water. Hang in there. I was strictly on the migraine diet and I try to avoid as many avoidable triggers as I can. It took me three years to recognize all of them. Gook luck. Sorry we are no longer carefree. (www.vertigotalesandtastes.blogspot.com)